New America Media, News Report, Anthony Advincula, Posted: May 13, 2013
Recently, three of Khorshadul Kabil’s children came home from school with high fevers. Dread set in for the 42-year-old immigrant from Bangladesh and his wife: three of their four kids have severe asthma. In a few hours, the children— ages 3 to 14— were heavily wheezing and coughing. Their father rushed them to a nearby hospital.
Kabil knows all too well that those symptoms can quickly escalate to a dire situation. The couple’s 14-year-old daughter has had convulsions. The 3- and 7-year-old boys have shortness of breath and chest pains at least twice a month.
“Our situation [is] not good,” said Kabil. “My job [doesn’t pay enough for me to buy] health insurance,” he said in broken English.
He works part-time at a small grocery store a few blocks from their rented house in Fort Lauderdale, Florida. His wife is a stay-at-home mom. There are times, he said, when they can’t afford to pay for their kids’ medicines.
The state has a health insurance program for low-income children, known as the Florida KidCare Program (http://www.floridakidcare.org/), but the Kabils don’t qualify to fully take advantage of it. That’s because the program has a five-year residency requirement. The family emigrated from Bangladesh to the area just two years ago.
Eventhough Kabil and his wife have the option of enrolling them in KidCare, they don’t, because they simply can’t afford it. Because the kids do not meet the five-year residency requirement, they have to pay much higher fees for each child — almost $200 per child as compared to $20 per month for all his children.
Momentum had been building in the state to do away with the five-year waiting period to get full coverage under KidCare. Two bills, introduced last year and sponsored by Republican Senator Rene Garcia (SB 704) and Republican Rep. Jose Felix Diaz (HR 4023), would have eliminated the five-year waiting period for lawful-residing children to be eligible for KidCare.
Both bills failed to pass in the state legislature last week. The fact that Florida is in the midst of ramping up for the onset of health care reform, including Medicaid expansion for low-income people, may have overshadowed the two bills.
In Limbo
In Florida, lawful immigrants are eligible for public benefits such as Medicaid and the State Children’s Health Insurance Program (SCHIP) only if they have been residing in the United States for five years. Under the 1996 welfare reform law — which introduced restrictions for federal income-based benefits related to immigration status and length of U.S. residency — 22 other states, including Washington, D.C. enforce the same eligibility requirement.
Since 2009, with passage of the Children’s Health Insurance Program Reauthorization Act (CHIPRA), states have had the option of extending eligibility for Medicaid and SCHIP to all lawful immigrant children residing in the United States, with no waiting period. The legislation provides federal matching dollars if the state does away with the waiting period.
Florida, however, has yet to change any provisions in its law.
In Florida, the five-year waiting period impacts somewhere between 20,000 and 40,000 immigrant children across the state, according to a Florida Center for Fiscal and Economic Policy (FCFEC) report.
The state’s five-year requirement gives these legal immigrant children no other option for public benefits such as Medicaid and SCHIP, advocates said, and it is more difficult for families and children, like Kabil’s, who need immediate proper health care.
Karen Woodall, executive director of FCFEP, said that unless the bill is reintroduced and is passed next year, these children would remain uninsured.
“The Affordable Care Act…does not remove the five-year wait,” she said. “These kids will continue to use a more expensive emergency-room treatment, and the government will pay more for these services.”
Linda Merrell, convener for Florida Child Healthcare Coalition, said: “For now, it’s a closed door. It’s lack of common sense not to pass it, but it’s surrounded by myths. We should move quickly.”
Advocates of SB 704/HB 4023, including Woodall and Merrell, believe that the bills failed to pass this year in part because they were overshadowed by larger healthcare debates surrounding ACA’s Medicaid expansion. Since Florida Gov. Rick Scott announced that the state agreed to expand Medicaid, state policymakers have given the Medicaid expansion a much higher priority this year.
There was also misinformation and confusion about the costs of eliminating the five-year waiting period and expanding Medicaid to include those children.
A fiscal analysis by Florida Agency for Health Care Administration (AHCA) showed that expanding healthcare to these lawful-residing children would dramatically increase the healthcare costs for the state. While this state agency retracted its previous high cost analysis later on, advocates said, the damage to the passage of the bills had already been done.
The Florida Center for Fiscal and Economic Policy contends that the maximum cost to the state to extend coverage to these children would be $17.6 million per year, an amount that could already be covered by unspent state funds already earmarked for children’s health coverage as well as funds freed up as a result of increased federal-match rates.
Florida currently receives about $39 million from SCHIP, but that amount would increase to slightly more than $63 million through CHIPRA if the state eliminated the five-year waiting period for legal immigrant children.
A strong anti-immigrant sentiment in the state, advocates say, also played a role in defeating the measures.
“There’s still a very strong anti-immigrant sentiment among legislators,” Woodall explained. “It does not matter whether these children are lawful-residing immigrants.”
Sponsors of SB 704/HB 4023 pledged to reintroduce the bills again at the first congressional session in 2014 or even earlier at a special session.
Life-changing Accident
Palm trees and white beaches were part of the American Dream for Kabil and his family when they first came to Fort Lauderdale.
“We love it here. The weather [is] like Bangladesh; it’s comfortable,” he said.
But, just a year after they arrived, things took a bad turn. Kabil had a hit-and-run accident that left him nearly crippled. The driver has not been found.
“I was walking to my work and the car came [from behind me]. I did not see it,” he recounted. “I was on the ground, but the driver did not stop.”
Although he can still walk, the accident has affected his mobility. He gets tired easily, he says, particularly if he works for a long time in a day.
“I need a doctor. My kids need a doctor,” Kabil said. “Every day we have health problems, but we have no medicine.”
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May 13, 2013
In the News